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Town of Barnstable Building
_ Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept
Q,�
Posted Until Final Inspection Has Been Made.
•bsa Permit
0►�3 Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made.
Permit No. B-20-629 Applicant Name: HERCULES COSTA Approvals
Date Issued: 03/24/2020 Current Use: Structure
Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 09/24/2020 Foundation:
Residential Map/Lot: 175-022 Zoning District: RF Sheathing:
Location: 23 DERBY DRIVE,WEST BARNSTABLE Contractor Name:
F
� Framing: 1
Owner on Record: COSTA, HERCULES Contractor License: 2
Address: 23 DERBY DRIVE -- - -- Est. Project Cost: $20,000.00
� Chimney:
WEST BARNSTABLE, MA 02668 4 Permit Fee: $ 152.00
f Description: finish the basement and build laundry/full bathroom Fee Paid: S 152.00 Insulation:
Project Review Req: MUST COMPLY WITH 2O15 IECC REQUIREMENTS. MINIMUM Date: 3/24/2020 Final:
CEILING HEIGHT SIX FOOT EIGHT INCHES. ✓ r_
Plumbing/Gas
Building Official Rough Plumbing:
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within,six months after�issuance. Final Plumbing:
All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas:
All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes.
This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas:
work until the completion of the same. f f
The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit.The
Minimum of Five Call Inspections Required for All Construction Work: Service:
1.Foundation or Footing
2.Sheathing Inspection Rough:
3.All Fireplaces must be inspected at the throat level before firest flue lining is installed
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final:
5.Prior to Covering Structural Members(Frame Inspection)
6.Insulation Low Voltage Rough:
7.Final Inspection before Occupancy
Low Voltage Final:
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations.
Work shall not proceed until the Inspector has approved the various stages of construction. Health
"Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final:
Building plans are to be available on site
Fire Department
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final:
Town of Barnstable MUST COMPLY WITH HOME OCCUPATION
Building Department RULES AND REGULATIONS. FAILURE TO
�oFj"E rOw,y Brian Florence,CBO CON4PI.Y MAY RESULT IN FINES.
Building Commissioner
BARNSrABLE, : 200 Main Street,Hyannis,MA 02601
owes.
i639, ,0� www.town.barnstable.ma.us
Office: 508-862-403 8 Fax: 508-790-6230
Approved:
Fee:
Permit#:
HOME OCCUPATION RRGISTRATION
Date: OGM
0 Phone#:��o' U0 10
Name: 1
Address: Z-3 :^�,-- Obu 1 Village: NS
Name of Business: YV
'
Type of Business: )
NS�C 0 N Map/Lot: a
INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation
within single family dwellings,subject to the provisions of Section 4-1:4 of the Zoning ordinance,provided that the
activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual
alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal
residential volumes;and no increase in air or groundwater pollution.
After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the
following conditions:
• The activity is carried on by the permanent resident of a single family residential dwelling unit,located
within that dwelling unit.
• Such use occupies no more than 400 square feet of space.
• There are no external alterations to the dwelling which are not customary in residential buildings,and there
is no outside evidence of such use.
• No traffic will be generated in excess of normal residential volumes.
• The use does not involve the production of offensive noise,vibration,smoke,dust or other particular
.matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects.
• There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess
of normal household quantities.
be met on the same lot containing the Customary Home
• Any need for parking generated by such use shall
Occupation,and not within the required front yard.
• There is no exterior storage or display of materials or equipment.
There are no commercial vehicles related to the Customary Home Occupation,other than one van or one
pick-up truck not to exceed one ton capacity, and one trailer not to exceed 20 feet in length and not to
exceed 4 tires,parked on the same lot containing the'Customary Home Occupation.
• No sign shall be displayed indicating the Customary Home Occupation.
• If the Customary Home Occupation is listed or advertised as a business,the street address shall not be
included
• No pens shall be employ d' the Customary Home Occupation who is not a permanent resident of the
dwellin unit.
1,the undersigned,h e e d ee th bove restrictions for my home occupation I am registering.
Date: 0 70 1
Applicant:
Homeoc.doc Rev.10/17
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map /7S' Parcel :6 C;ca ' Permit#
Health Division ki0r'- ?✓ 7 V a407i F: - Date Issued '!1 9T-9
Conservation Division 1) Nt, Fee 1 Y 00
Tax Collector
Treasurer SEPTIC SYSTEM MAST DE
INSTALLED IN COMPLIAACE
Planning Dept. WiTH TITLE 5
Date Definitive Plan Approved by Planning Board ENVIRONMENTAL COD �`�
TOWI!1 REGULAT'. J
Historic-OKH Preservation/Hyannis -�
Project Street Address 23 6'2_1i6 [ ,
Y
Village 1r.)e,57'- k-
Owner CO 2,u .� `S�, E�i Address 23
Telephone 3-0 ' VZ o
Permit Request
3
/ .S e� �5��✓/yo-'f'I ®mac/ /J�,/ �:5 w, L��ooc�/ ���
f� ec �i>i✓ �' �oa� ��il�v i-vim IUC��c ��/� J� ( � y
Square feet: 1st floor: existing proposed 2nd floor:existing proposed Total new
Estimated Project Cost Zoning District Flood Plain Groundwater Overlay
Construction Type /
Lot Size Grandfathered: -;"Yes '),WNo If yes,attach supporting documentation.
Dwelling Type: Single Family Two Family ❑ Multi-Family(#units)
Age of Existing Structure Zd Historic House: ❑Yes 'tYNT— On Old King's Highway: ❑Yes
Basement Type: -Moll ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) �y�� Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing °+' new /� Half: existing new 4 ,
Number of Bedrooms: existing 3 ew
Total Room Count(not including baths): existing new First Floor Room Count
Heat Type and Fuel��Iftas ElOil ElElectric ❑Other
Central Air:-ems ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No
Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size
Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes 'IEiPdo If yes, site plan review#
Current Use Proposed Use —7
I
BUILDER INFORMATION
Name Telephone Number 3Z55r- 2�'93
Address6y e!Q- 73 License#
Home Improvement Contractor# /Z slCo
Worker's Compensation# 3.5—- -S9-` Z 1!5 f-6
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE c �� DATE _ -7 y
r
FOR OFFICIAL USE.ONLY
PERMIT NO. s '
DATE ISSUED +
Y�
MAP/PARCEL NO.j' `
ADDRESS, '' ' '' VILLAGE
OWNER
DATE OF INSPECTION:'°
FOUNDATION
FRAME
t
INSULATION ' ?
FIREPLACE
ELECTRICAL: ROUGH, FINAL
PLUMBING: ROUGH + • ' FINAL
GAS: ROUGH . FINAL
FINAL BUILDING
' _ 4
DATE CLOSED OUT
ASSOCIATIONTLAN NO.
i
n r ,
• -- �F Zf1E T
The Town of Barnstable
• a�aHsr� • .
� Department of Health Safety and Environ`hii6tal Services
iOjEo ` Building Division _
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
For office use only
Permit no.
l
Date
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization,
conversion, improvement, removal, demolition, or construction of an addition to any pre-existing
owner occupied building -containing--at�•least:r.one but not more than four dwelling units .or. to,
structures which are adjacent to such residence or building be done by registered contractors, with
certain exceptions,along with other requirements.
Type of Work: Est.Cost 8bo a
P _
Address of Work: 23
Owner's Name Z29'u
Date of Permit Application: -7L,:�'
I hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law
Job under$1,000.
Building not owner-occupied
Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of the owner.
Date Contractor Name Registration No.
OR
Date Owner's Name
r
'.06/22/1999 15:06 508420345551 PAGE 02
OPEN SPACE
LOT
LOT tip` 64
65
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63
L=40
R=s0 00
DER-BY
DRIVE
c a
p (fnd)
)W ZONE, 'Wr This MORTGAGE INSPECTION Plan Is For FLOOD ZONE- "C"
TO WN: ---- REGISTRY OWNER: FAE,�AL�LQ.41v�24E1�P
DEED REF. DQ, .7_—___ -BUYER: 11�11YlELL _Srf�lTK C LE �,—
DATE: �4 _ --- PLAN REF: _PS 2C _SCA .1 — —
1&Mg�H
AGGRTIFY 'I'o _ __ ___ _THAT THE BUILDING �K or YANKEE SURVEY
SHOWN ON T—HIS PLAN ISWLOCATED ON ME GROUND AS f�� CONSULTANTS
SHOWN AND THAT ITS POSITION DOES —' CONFORM ���
6 PAUL
A. 40H (SUITE 1)
TO THE ZONING LAW SETBACK REQUIREMENTS OF THE �:,.;
TOWN OF ___ I�H,�T.9,� _ �1ND THAT MamTHm a INDUSTRY ROAD
IT DOES_1�� D_ LIE WITHIN THE SPECIAL FLOOD HAZAR ' �O's�OpB UAR5TONs MILLS, MA. 02648
AREA AS SHOWN ON THE H.U.D. MAP 0 DATED_ /J,,9/W _ � °'GGjstE TEL: 428-0055
,250 0 °` F 20--5553
THI— PLAN NOT MADI
---�--- s
s Y NOT TO BE USED NCES 15529 DPC
-";A sFt;',. �� �:•r —'__•"` the Coinntwroveullh uf*ti•tossurhnsells
ff L•/,'+.SkJ'){; :�I;1�.-'�� (Ne Depurintenl of lnduslrial.'Iccidertls .
011/ce o//nvest/gat/ons '
nY 14Gi{�'! c `l t ( c•� ?',; � Boston, Mass. 02111
,y a
{; 4D�.L�s• .. • e
of ,� Workers' Compensation Insurance'Afiida+it
t. u t2rite: V .005�54� �/i �,a 4eOO SdV +
_hones Sdf—3�3-GYGo i
f j I sm a homeowner performing all Nark myself.
r 1 I'am a sole proprietor and have no one working in any capaciri �-
t..." ? I am an employer providing workers' compensation for my employees working on :his job.
��'� f f •a v �R7Z� ,�pe,r,� � t�DS'EO't/ ' .`y,'� x' � ..
.. ,'•, ,�ti!R41 name ', �r tip.
c :aL�{ i thane y SZ���.3�1 or Yt�d <. '. -•;7 s'i:'
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i ce �,;+t 1,••t1r9flr�,•a `ri7` /U , .�OIICV d �.V '• �T �L'$ Q /
-al cootraetor,or homeowner(circle one) and bave hired:be contractors listed be
,] I am a sole proprietor,gene low who have, ti w.' ;
the following workers' compensation policat }
6 ,�. '^ - -Etta '' ,' • -.,
policy%4
SMOM
�ti Y �� :lt�. '. . phone d• -_ ?� i#�Y °�
is 1n ti *i.r-+7 t1
s ?i at phone y:
r , v Intorince co.
L .•1X Y `,tit
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tae It-Tda 0 oo Iili—c lfieeei,a l" '
; FI slut J:to fecure:overate ff required under Section:5A or.%IGI.Is:con lead to the impoillloo or criminal peoill of a nat ap 10$13oo.00 foodtor F ��,?•", r ti„
:`i �•,• s',►nt.�we imprifonmtnl is well it civil penalties in Iht rerm off STOP WORK ORDER and a Bne of S100.00 t day aRalout me. 1 usderfea.d tAat a�
'�i`'>`•t�; „ o.Ir Ihit itultmenl m+ ht forwarded to the orrice of InvNiiefuenf or the Ol,e for tovenct enncadon.
y�r �,/e fltitby ctni/I•under the point and penalties o/perf un•that the informationprovidtl!'obovr l7 trvt andcorrect ;j+
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BOARD OF BUILDING REGULATIONS
License: CONSTRUCTION SUPERVISOR
I Number: CS 074251
B I rt h d a te: 03/09/1963
Expires: 03/09/2003 Tr,no: 74251
Restricted To: 00
JOHN K ESLER
100 OTIS STREET
NORTHBORO, MA 01532
Administrator
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E)"rUP10 ROOM F-i-001: 'LAN
RAIN GUTTER - ALUM. PANEI. MANGER
—' r�`r --- - i:UNPIECTS TO WAIL. S RJUS
EXISTING
HOUSE
ALUM. SLIDING DOOR 13.
TEMPERED GLASS a)
SLIDING DOOR ON SILT_ t" (;()II(; ;I AB 4Y/
SECTION W/ DOOR FLOOR
. .
EXPANDER FIXED TO CONC. Gx6xW2.9xW2.9 1YPICAI_I-- EXP. JOINT—
FLOOR
APPROX. GRADE — .--._— ---- - --4 ---
B" THICK POURED C0NC. F1G.
BOTTOM OF FOOTING TO REST QN
UNDISTURBED SOIL BELOW FROST' LINE. .'
5TUDIo R00f,+I-C-I 10N A-A(CONCRETE FLOOR) 1 ��
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SEE NOTE ON P AGE 5.0.2
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SLIUIIJG DOOR OH SIIL II't+ Ill l'c'm' PI(Y.Lti AS
SEC7NIN t9/ UQi pt I'(OU17 I-� "-"p1[f;IAR[l) FOR .111A1;1 U.1(111
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Ill I11151111t11LD _011, III I11'N 1Ito';I ll::I
51 UP10 RDOId 5ECTI01d A-A(WOOL)FLOOR)
NOTES FOP FIGURE 50-1 AND 50-2
1) STRUCTIJP.AL Iv1Etv1BER5 51-IAI_I_(,'Oh/lf'P15E 60631'6ALLItvlll,lUM EXT P.U510N5
5UPPI-IED I3Y CPAI=T:-I')II_r lvlAf,lUFACTURING COMPA[IY
2) POOF PAttIEL5 51-IAI_I- CON515'I"OF CAPDI30APD I IOFIEYCOMB(1-•IC)OR EXPANDED
POLY57YP.EHE(El-5)PANELS 5UPI'LIED BYCPAFT-1311..rtvlAt`I(IFACTUPft`IG COMPANY.
3) MAXIMUM 5FAHS OVER 00015 431 IALL.BE 87".
4) ROOF FANEL5 51-IALL HAVE A tv IHIMUM FAC-IOI:OF 5AFElY OF 2.5 AND 51-IALL
DEFI_ECr l_t=55 TI-IAN.5FAWWO AT TI IE DE51GN LOAD.
5) ALL 5TRUCTURES 5f-IALL I31'11,151A1.1_I U ACC,ORL)ING 10'l l IE MANUFACTURE'S
COMPANY RECOMMENDAT101,15.
6) LOADINGS:
ROOF: SNOW LOAD 35 F5F
WIND LOAD 20 FSF
DEAD LOAD 2 FSF
WALL:
WlN1)LOAD 20 PcjF
DFCK:
LIVE LOAD 'IO F5F=
ESTIMATED DEAD LOAD 10 F5F
7) IIMDEE DE5IG.H.51 E55E5:
5FECIES 50UT HERH PINE 1,10.2
BENDING 5TPE55 F1) WOO F51 (REFETITIVE)
COMFPE5510H FERI'I HDICULAI
TO GRAIN Fc 565 F51
SHEAR PARALLEL Tyr(RAIN Fv 90 F91
COMFRE5510N FARAH.E1.."I"0 GRAIN Fc 975 F51
MODUI_U5 OF ELASTICITY E 1,600,000 F5l
ALL TItvIDER51-IALL FIF PF;L=5:11.1RE'I PEAT1_D
8) _5QIL.13EARIIJG CAPACITY:
FOO rI1'I65 51-IOUI_D F'1=51'ON 5011.1 IAVIIIG A P,111-4/I1.11 i fliEARIHG CAPACITYOF
2000 F5F.
9) E 0 0 T 11,16
FOO r11,I65 51 IALL I3E LOCAI ED 13El_OWFR05-l'LINE.FOOTINGS 511AL1_BE SIZED
ACCORDING 1 O THE Al'FI_IED LOAD AND LOCAL-5011_BEARING CAFACrrY.CON ETE
151O HAVE A MINIr+1 t�fLc�luiE'rzr-�Fn/r=�, �TI I OF300o F51 Al-28 DAYS.
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I Uf)101900M FLOOR FLAN
RAIN GUTTER ALUM. PANEL I1ANGER
`-1 y� I:clru rEc rs r0 wn G' stuns If
EXISTING
HOUSE
6
ALUM. SLIDING
TEMPERED CLASS— ----- :m
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SLIDING DOOR ON SILL_ a" CUrI(: sl_nD 4v/
SECTION W/ DOOR FLOOR
EXPANDER FIXED TO CONC. Gx6xW2.9xW2.9 TYPICAL - EXP. JOlrll"
FLOOR
APPROX. GRADE — -- - .__- —- ------ —t -- - —
B" THICK POURED CONC. FIG.
BOTTOM OF FOOTING TO REST ON -
UNDISTURBED SOIL BELOW FROST LINE
I:
5•(UD15 R OOI`,I 51-C1"I0PJ A-A(CONCRETE FLOOR) �
SEE NOTE5 ON P AGE 5.0.2 n
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Iln UlS IIIItI1ED SUq 1!1.11I:Y NW'.I'
51"I IDIO R001�1 SECTION A-A(WOOD FLOOR)
NOTES FOR FIGURE 50-1 AND 50-2
1) 5TRUCTUP.AL tvIEMBER5 5f IAI_I_COMPRI5E 6063'16AI_UMIIdUM EX-fPU510N5
5UPPLIED f3YCP.AF I=f')ll_f MAt,IUFACTUIZIt,IG COMPAI,IY.
2) ROOF PANEL5 5I-IALI_ CON515TOF CARDBOARD I IOt`IEYCOM13(I-IC)OR EXPANDED
POLY5-fYREl'IE(EP5)PAIJELS 5 UPI-LIED 13YCRAF-f'1311:f t,IAI`ILiFACfUPIt,IG COMPANY.
3) MAXIMUM C),M,15 OVER D001'15 51 IALL BE 87".
4) ROOF PANEL5 51-IALL I IAV[=P,M11,11M[JPv1 FACIOR OF 5AFE1I Y OF 2.5 AND 51-IALL
DEFI_ECf LEf�)5-fflAt l"5PAN/12.0 ATTI IE DL=51GN LOAD.
5) ALL 51-RucTURE551-IAI_L[31;:It`I51AL1_EDACCORDINGTOTHF:MANUFACTURE'S
COMPANY RECOMMENDATIONS.
6) L0612ING5:
ROOF: SNOW LOAD 35 P5F
WIND LOAD 20 P5F
DEAD LOAD 2P5F
WALL:
WIND LOAD 20 P5F
DECK:
LIVE LOAD CIO P5F
ESTIMATED DEAD LOAD 10 P5F
7) 71MDEE.DE 51GH.51 E5.5E5:
5PECIE5 501J1-I•IERN PINE 1,10.2
BENDING 51-RE55 Fly MOO P51 (REPETITIVE)
COMPRI=SSIOt`I PL'Rf'l:t`IDICIJI.Af;
To 0-RAIN Fc 565 P51
51-IEAR PARALLEL-10GRAIN Fv 901251
COMI'RE551ON PARA1.1_EL.IO GRAIN Fc 9751951
MODIJI_05 OF ELA511C.1 IY E 1,600,0001251
AI_L'I It�`IfiE1:51 TALI_L%I.f'F;L`3 �Ilfa: I REAL l-0
8) -501L 6EAKT IG CAPACITY:
FOO FING5 51 I011l_D 50I1.HAVING A P(11hIlI),IUlvl f51_Af'11,167CAPACITYOF
2000 P5F.
9) FOOT1I,I.G.S:
FOOTIVIG5 51-IAI_L[31-I.00AI ED 13ELOW F '05111HE.FOOT-1NG5 51-IALL BE 51ZED
ACCORDING TO THE AI'PLIL=D LUAD AND LOCAL 5011_BEARING CAPACITY.CON ETE
15 TO I IAVE A fv1INI11 �TIIOF�3000�F51AI�'28(fY5.
etterlOving
M S
englem5(Isly-1 47,,,5
I
=,��y�`fit;•:';•"r;3!, ,•
4.
',•a.�,.,j`•,r,,i,��a,�4;r. Property Owner Must Complete and Sign This Section If Using a Builder
I, AiiX c_� , as Owner of the subject property
hereby authorize ^-fo act on my behalf, in
...... ``: '' all matters relative o work authorize by this building permit application for (address of
job) 3 Qc&6�4 4a &0 A),r i.4,�lL 0"Z 6,6 d
Sig re of Own r Date
it
Owner or Builder(as Agent of Owner) Must Complete and Sign This Section
as Owner/Authorized
•!�,;-';=`'Agent hereby declare that the statements and information on the foregoing application for
are true and
(address of job) Z
accurate to the best of my knowledge and belief.
Signed under the pains and penalties of perjury.
{r _ i2•p t y �• � ti
Print Name
Signa ure of Owner/Agent Date
i
23 DER3Y DRIVE
W. �ARNSrA- 15LE MA 42_6643
10
• � 1 I; j ij j� ! I i
EXIST I N(-, T)ECK C I ax t6
' __.2.x $ FRAME @ 2-4 " o L
I
60LTE..D AT "DVtSEWA�-L..
SOLI'O I3�.Q�kiNC� ('VMOSPAt4
ZxG DECKING
13" DIA x (A%" OCEP
p STU DID- St A-G
PAT1 D RNLI-C6U R�
_ - _ �,, x . _ -...�.. ,.m ==Z, �.y •1'ufr'�y] -�•A`�X>f�771r'9SiG
assac u, ,. Oi.l���'.�°�d�
The Massachusetts State Building Code (780 CMR) includes provisions to ensure that houses and
house additions meet energy efficiency standards. This supplemental CONSUMER INFORMATION
FORM is to be filed as part of the building permit application when a builder/contractor or homeowner,
constructing/installing a house addition with very large percentage of glass to opaque wall, seeks to utilize a
special energy conservation exemption option for "sunroom" additions to an existing house (780 CMR,
Appendix J, Section J1.1.2.3.1). This FORM is not intended to prevent a homeowner from selecting a
"sunroom"of any size, configuration, orientation, form of construction or percent glazing, but rather is only
intended to assist homeowners in becoming aware of some of the important energy conservation and year-
round comfort considerations involved in selecting and utilizing a"sunroom"addition.
The connection of "sunroom" structures to residential buildings may create comfort and energy
consumption issues due to uncontrolled solar gain or uncontrolled radiation cooling of the main house. In
the selection and construction/installation of"sunrooms", included below is a non-required, open-ended list
of product and design considerations that a homeowner may wish to consider before actually
constructing/installing a"sunroom". It is recommended that consumers carefully review these options with
their designer, builder, or contractor, in order to minimize potential energy consumption and/or house
discomfort issues. In addition, the qualifications and reputation of the company or individuals to be hired
are important considerations.
PRODUCT AND DESIGN CONSIDERATIONS RELATED TO"SUNROOMS"
• Solar Orientation and Natural Shading
• Type of Glazing
• Insulating value
• Solar heat gain
• Frame materials
• Glazing to frame sealing and gasketing materials/seal durability and/or
weather tightness of the sunroom
• Adequate ventilation-Operable windows and fans
• Applied Shading Systems
• Insulation level in floors,walls,and ceilings
• Possible Sunroom isolation from the main house via a wall and/or door or slider
• Heating and Cooling Methods: Efficiency,Zoning and Controls
Homeowner Acknowledgment i
The Massachusetts State Building Code, Section J1.1.2.3.1, requires that the actual property owner(not the
owner's agent or representative)acknowledge receipt of this CONSUMER INFORMATION FORM prior to
issuance of a Building Permit for a project that includes "sunroom" additions to an existing residential
building. In accord ce w' this requirement, the undersigned hereby acknowledges that she/he has read
the 'n rmation ' ent concerning sunroom comfort and energy conservation.
lsi� ature of Actu B �Iding Owner Date
Print Name Address of Permitted Project d Z 6
`fd U
Owner Address(if different than project location) Owner's telephone number
r..
e en' RUM A �1 • eg` la�y,�adais 'unrooms
Exception:Sunroom Additions/Consumer Notirication: Sunrooms, as defined in 780 CMR
Appenidix'&d DEFINITIONS shalLbe exempt-from the compliance requirements set forth in 780411
'
CMR J1.1.2.3.1 and J1:13'provided that thectuat a p' perty owner(niottihe owner's agent or
representative) of the structur@ onto which the surir"oom addition is being made,provides a signed
copy of the Sunroom"CONSUMER INFORMA`1I014 POW,(found in 780 CMR,Appendix B)
to.the Building Deparhm6t. This signed"CONSUMER INFORMATION FORM" shall be
submitted to the building official as a requirement of building permit issuance;and shall remain as
part of the construction documents. If such sunroom additions are separated from the main house by
a wall and are conditioned spaces,then a readily accessible manual or automatic means shall be
provided to partially restrict or shut off the heating and/or cooling input to the sunroom addition
space. That portion of a wall that separates the sunroom addition from the existing
building/dwelling unit, if an existing exterior wall, shall be allowed to remain and neither that
portion of said wall or any fenestration within said portion and common to the sunroom addition,
need comply with the thermal envelope requirements of Appendix J.
n o t 2 0'+DFs
780 CMR J2.0 DEFINITIONS .
SUNROOM: An addition to an existing building/dwelling unit where the total area(rough opening
or unit dimensions)of glazed fenestration products of said addition exceeds 40%of the combined'
gross wall and ceiling area of the addition.
irk
ea �u�Y�e,anv � ba laces `edqinm ' later °yU
i
CAPE COD
INSULATION
Fq N R
NIl GU$5 UAM US SMYFSAM SYSRNYIY
MiTS "11.5 1"wLawl" QRM
1-800-696-6611
Town of
Regulatory Services
Building Division
Address -
Address 2 -
Date:
Dear Building Inspector
Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed &
completed the insulation and weatherization work at the property listed below. Cape Cod
Insulation did this in accordance to the specifications listed on the building permit
application. All work has been inspected by a certified Building Performance Institute
(BPI) inspector. All work preformed meets or exceeds Federal & State Requirements.
Property Owner Property Address Villalze
Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted
Ceilings ( ) (NX) (30
Slopes ( ) ( ) ( ) ( )
Floors ( ) ( ) ( ) ( ) ( ) Z
Walls w
Sincerely
enry.E Cassidy Jr, President
Cape Cod Insulation, Inc.
i
r'
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map f Parcel V "� Qpp9ication #CC
Health Division Date Issued
Conservation Division Application Fee
Planning Dept. Permit Fee
Date Definitive Plan Approved by Planning Board
Historic - OKH _ Preservation / Hyannis
Project Street A dress xy v,
e VU
Villa ib �,�/v[�� IO
9
Owner a,, A��� Address
Telephone— [;? 0 Z h27
Permit Request w�i tZ I Vly w r�lt V
k t�, 1 G41;3 P_-fib 5�a
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation Construction Typed
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family Two Family ❑ Multi-Family (# units)
Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No
Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other
Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft)
Number of Baths: Full: existing new Half: existing new
Number of Bedrooms: existing _new
Total Room Count (not including baths): existing new First Floor' m Count
Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other w
Central Air: ❑Yes , ❑ No Fireplaces: Existing New Existing woo coal stone: C 'es ❑ No
=-- 'Lf'
Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existinguJO n9A size_
m
Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: ' rn
Zoning Board of Appeals AZo
thorization ❑ Appeal # Recorded ❑
Commercial ❑Yes ❑ If yes, site plan review#
Current Use Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name NC4Telephone Number
Address U V License # 009
NA d I Home Improvement Contractor# rJ��
Email Worker's Compensation # We of zlf)q U
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PR JECT WILL BE TAKEN TO
mv Va
SIGNATURE DATE 1
` FOR OFFICIAL USE ONLY
APPLICATION#
DATE.ISSUED
` MAP-4 PARCEL NO.
s
ttk
fr
E,
r ADDRESS VILLAGE
OWNER
s-
DATE OF INSPECTION:
i
t FOUNDATION
FRAME
INSULATION
FIREPLACE
3
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING.
DATE CLOSED;OUT
r A§§OCIATION PLAN NO. `�
- u .
Massachusetts - D6partment.of Public Safety
:.Board of Buildi6g Regulations and Standards
Construction SuperN.isi�r
License: CS-100988.,
HENRY E CASSID
8 SHED ROW +
WEST YARMOUM 3
1 �
„ w Expiration
Commissioner 11/11/2015
F
� Uy
a Office of Consumer Affairs and Business Regulation
10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration
Registration: 153567
Type: Private Corporation
Expiration: 12/15/2016 Tr#. 259188
CAPE COD INSULATION, INC
HENRY CASSIDY
18 REARDON CIRCLE ---
SO, YARMOUTH, MA 02664
Update Address and return card. Mark reason for change.
'CAt ti 20M•05n1 Address Renewal Employment ❑ Lost Card
Gvl;e�pai��r�zoraruea.�C/z n`'P/T/r✓rWdr�c/uaeGi
.C\ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only
OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
egistration: `1.53567 Type: office of Consumer Affairs and Business Regulation
xpi ratio n:;:,::4.21.15/20:1.6 Private Corporation 10 Park Plaza-Suite 5170
= y Boston,MA 02116
CAPE COD INSULATI;Q:N; NC'.
HENRY CASSIDY -
18 REARDON CIRCLE" ? 4971 �
SO. YARMOUTH, MA 02664 Undersecretary qNvalidwi. ut sign e
The Commonwealth of Massachusetts
Department of Industrial Accidents
w W Office of Investigations
Y
a
d 1 Congress Street, Suite 100
Boston,MA 02114-2017
www mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information �� //w Please Print Le ibl
Ck
Name (Business/Or 'zation/Individual): Q el% tW.
Address: `� V �� V �I " —
City/State/Zip: m Vl• I "t� Phone#:
Are you an employer? Check 1he appropriate box:
general contractor and I Type of project(required):
1.$2 1 am a employer with 4. ❑ I am a g
employees (full and/or part-time).* have hired the sub-contractors 6. ❑ New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have g. ❑ Demolition
working for me in any capacity. employees and have workers'
[No workers' comp. insurance comp. insurance.$ 9. Building addition
required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.7 Roof repairs
insurance required.] t c. 152, §1(4),and we have no 13. Other I�( {'(t}4
employees. [No workers'
comp. insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit thisIffiidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
Information.
Insurance Company Name:
p Y r/�- m
Policy#or Self-ins, Lic. #: i �V Expiration Date:
Job Site Address: City/State/Zip:U/•
Attach a copy of the workers' com ensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify n r pains and penalties of perjury that the information provided Bove true qnd correct.
Signature: Date:
Phone#:
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/License #
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
3
i
.� I �v 1
) � I
r
�•� CAPECOO-27 KLIGETT
CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFIC 6I13/2014
ATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsements).
PRODUCER CONTACT
Ro ers 8 Gray Insurance Agency,Inc. NAME: Barbara DeLawrence PHONE
43 Rte 134 A/c No: (877 816-2156
South Dennis,MA 02660 ADDRESS: bdelawrencegRrogersg ray.com
INSURERS AFFORDING COVERAGE NAIC f
INSURER A:Peerless Insurance Company
INSURED
INSURERB:COMMERCI= INSURANCE COMPANY
Cape Cod Insulation Inc INSURER C:Evanston Insurance Company
18 Reardon Circle INSURERD:ATLANTIC CHARTER INSURANCE GROUP _
South Yarmouth, MA 02664
INSURER E
INSURER F:
CO ERAGES CERTIFICATE NUMBER: REVISION NUMBER:
T IS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
IN ICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
C RTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR n
LTR TYPE OF INSURANICE D POLICY NUMBER MMIDD YY MM2120 YYY LIMITS
A X COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE $ 1,000,000
i CLAIMS-MADE �OCCUR CBP8263063 64/01/2014 04/01/2015 PREMISES(Ea occurrence $ 100,000
MED EXP(Any one person) $ 5,000
PERSONAL 8 ADV INJURY $ 1,000,000
GEN'LAGGREGATE LIMIT APPLIES PER:
X POLICY❑PRO-JECT El LOC GENERAL AGGREGATE $ 2,000,00
PRODUCTS-COMP/OP AGG $ 2,000,000
OTHER:
Arx
TOMOBILE LIABILITY COMBINED SINGLE LIMIT
B Eaaccident $ 1,000,000
ANY AUTO 14MMBCKVMK 04/01/2014 04/01/2015 BODILY INJURY(Per person) $
ALL OWNED X SCHEDULED
AUTOS AUTOS BODILY INJURY(Per accidenl) $
HIRED AUTOS X NON-OWNED
AUTOS PROPERTY DAMAGE $
Per accident
• X UMBRELLALIAB• X OCCUR .
1 EACH OCCURRENCE $ 1,000,000
C EXCESS LIAB CLAIMS-MADE XONJ453514 04/01/2014 04/01/2015
DED X RETENTION 1�'v 00 AGGREGATE $
ORKERSCOMPENSATION Aggregate $ 1,000,000
ND EMPLOYERS'LIABILITY STATUTE �RH
D NY PROPRIETORlPARTNER/EXECUTIVE Y/N WCA00525904 06/30/2014 06/30/2015 FFICER/MEMBER EXCLUDE N/A E.L.EACH ACCIDENT $ 1,000,000
I
andatory In NH)
as,describe under E.L.DISEASE-EA EMPLOYEE $ 1,000.000
ESCRIPTION OF OPERATIONS below
E.L.DISEASE-POLICY LIMIT $ 1,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Addltlonal Remarks Schedule,may be attached If more space Is required)
Workers Compensation Includes Officers or Proprietors.
Additional Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder.
CER IFICATE HOLDER _ CANCELLATION
HOME OWNER WEATHERIZATION WORK PERMIT:
PLEASE COMPLETE AND SIGN THIS FORM AS
THE APPLICANT HOMEOWNER.
hereby consent to and agree that weatherization work
may be done by the Weatherization Program of Housing Assistance Corporation on the property
located at:
The weatherization work done will be based on programmatic priorities and availability of
funding and it may include all or some of the following measures:
Weather stripping; air sealing; attic& basement insulation; exterior wall insulation; ventilation
measures In consideration of the weatherization work to be done at my home I agree to the
following:
1. I give permission to Housing Assistance Corporation the property with such equipment
and materials as may be necessary to perform weatherization.
2. The Housing Assistance Corporation reserves.the right to inspect the fuel or utility bill for
the weatherized unit on an ongoing basis for no more than five (5) years after the
weatherization work is completed.
I have read the provisions of this agreement and give my consent.
Home Owner(signature)
Home Owner email: i ckn Me-; oe Date: Iz- )'E -au 1 `�
J f I
Agent:(Signature) Date:
Weatherization Contractors:
Adam T Inc Cape Save
All Cape Energy Frontier Energy Solutions
Alternative Weatherization Lohr Home Improvement
Bui tion Resolution Energy
Cape Cod Insulation J Tupper Construction
of �� TOWN OF BARNSTABLE Permit No. ..2 .MI.......
BUILDING DEPARTMENT
TOWN OFFICE BUILDING Cash
HYANNIS,MASS.02601 Bond ....a.. `...
CERTIFICATE OF USE AND OCCUPANCY
Issued to
S T. S Tr�ict
Address Lot #64. ' 23 Derbv Lane
T.T.,na
USE GROUP FIRE GRADING OCCUPANCY LOAD
THIS PERMIT WILL NOT BE.VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE.
September25. I ....86......... �G..i.% ............,.... .... .............. .... ........ ..
Building Inspector
r' .-�" L. •-. -:.�• _ -r.. .,r •}i' r .!• . . ���� =��•e.. 'ti:X �1,;n rp�i' ..:.-v ;:efri,,: *-fi:�w^? ..►-.�.y«KtY•i��r.-�-.
TOWN OF BARNSTABLE
BUILDING DEPARTMENT
»ST TOWN OFFICE BUILDING
rua
HYANNIS, MASS. 02601
MEMO TO: Town Clerk
FROM: Building Department
DATE:
'An Occupancy Permit'has been issued for the"building authorized by
BuildingPermit #........ �ay.................................... _...................._...._._.._...............
_
issuedto ................ .............. .................................._...._...................._....._.�._..�..�..........._..... ._.__.
i
Please release the performance bond.
+ .,...g,•;,.. rle._ _ �' k.-�:r-.. .nrx"- irmr-ay. - :.,t.
,
I .
ff ILDING
TOWN OF BARNSTABLE, MASSACHUSETTS �.. PERMIT
i
A-151-4 & 6 JOB WEATHER CARD
DATE
29 1,3� PERMIJ„NO �Q a^
Lebel follows 1 oute 11 LL, �� 1.)
'APPLICANT ADDRESS
IN0.) (STREET) (CONTR'S LICENSE)
Build dwelling 1$ Single family dwellingUMBER OF 1
STONY `DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. ;\ (PROPOSED USE) -
;lo.t+ b Derby rive, West Barns a ZONING RF
AT (LOCATION) I DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
/
1
j TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
j (TYPE)
I Sewage #86-27
� REMARKS:
i,
bG D,
AREA OR 1900 sq. ft. 50,000 PERMIT 110.50
VOLUME ESTIMATED COST $ FEE
(CUBIC/SQUARE FEET)
OWNER S L S Trust
Route 13Z, Hyannis, VIA BUILDING DEPT. t�•.� [,i `. t� ( i �(
ADDRESS BY 7
'. _ j I
i THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART TFIEREOF,IEITHER TEMPORARILY OR
PERMANENTLY.-ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED'UNDER TIJE,BUILDING CODE, MUST BE AP-
► PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED
{ FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS
OF ANY APPLICABLE $SUBDIVISION RESTRICTIONS.
'MINIMUM OF. THREE -`CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE
I INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR
ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND
1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS.
2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL
MEMBERS(REAOY TO LATH).3. FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE. J
OCCUPANCY.
POST THIS CARD SO IT IS VISIBLE FROM STREET
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
1 1 1
z z, //�
y zl%�/��<
3 6: HEATING INSPECTING APPROVALS R&gVjEfATIqV INSPECTION APPROVALS.,
E.
i
ER G
O'HER 2 �(5epT 1066.. - -- - OARD OF HEALTH.
/1 eL- ►
IV
'NCRK SnA.L_ NCT ?ROCEED UNT:L THE PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION iNSPECTIONS INDICATED ON THIS CARD
:NSPECTOR SAS AP?ROV9_0 74E VA?ICUS WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE CAN BE ARRANGED FOR BY TELEPHONE
r - rmn rr OR WRITTFN NOTIFICATION.
''a•sg.
"-r 6115
P
- ��uNDAT\ON ••
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JOB # 85-215
CERTIFIED PLOT PLAN
LOCATION: L-64 DERBY DRIVE PREPARED FOP:_
SCALE: 1=40 DATE: 5/23/86
REFERENCE.
PB 405 PG 002 LEBEL / SOLLOWS
I HEREBY CERTIFY THAT THE BUILDING _
SHOWN ON THIS PLAN IS LOCATED ON THE
--- -GROUND--AS -SHOWN-HEREON• - --- - _ �? -
ARNE
H.
down cape engineering °J"L" '
�t f
CIVIL ENGINEERS �';�^ Cis- '
LAND SURVEYORS 2 /1F4
ROUTE 6A YARMOUTH MA DATE REG. LAND SURVEYOR
DECEIVED
Asse9e&Y's'map and lot number .. ........ � � �
���'THE
Sewage Permit -number g a`.�....... UST B'............................
• SEPTIC SYSTEM
' PLIAN
- INC.; LLED IN COM BaBa9T11DLE, •
�/ qq 9
House number .....�..�.•..�J......�........�.........::.........
WITH TITLE 5 , 1639-
"6°`
+ ' N NTAL CODE �Q►N�'''�a MIR a.
TOWN - OF BARl�' ►% 0I0Ns
BURRING ,- INSPECTOR
APPLICATION FOR PERMIT TO �.��. ................................ 6Z.. . ...........................................
TYPE OF CONSTRUCTION ..... W ............ �,,................................. .................
................................. . o
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a per�m.)iitt according to
the following/informat ra:
Location .......... ......... ........... 1%`�/[/... ...... ........... .... ..... .g� ma y !.`! ... .... ......................
.. .. ... . .. .. . ...
ProposedUse ...... .. [f�YU.... ..................................................................I........ :..................................................
ZoningDistrict ...... ... ... ........................................................Fire District ......... .. .... .....................................................
i
Name of Owner .................� ..h- ........: 1� .Address ..../.jj j.......(���•..
Nameof Builder . ... .\.. . ..... ... ..... ....... G...O.�.,�.......Address ..........................................:............,...........................
Name of Architect ... . . . .... ... ..... . .. ......... , ddress
Number of Rooms ................ .. ............................................ v v2��
..................... .......................... 0(7
. ..,..............................................
/i
Exterior ...... /.>�?1 .. ....� ..............................................Roofing ...............v. ... ....., ......................................
Floors ............. .............. ..........................................................Interior ........... .....................................................
Heating ..,-/ .Plumbing ....... ... .. �...`...r ..
Fireplace ...............................................Approximate. Cost ........... . ....... .................................. . ......
el
Definitive Plan Approved by Planning Board -- - - _-19 s
� .. Area 1 ......
... S'............
' O
Diagram of Lot and Building with Dimensions Fee ......//0 oz,
.............................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
l
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regardin the above
construction.
Nome . .. ..� .. .. .... ....... .. .. .:....X.�l�(
_. Construction Supervisor's License ..0 �� '
L S TRUST A=151-4 & 6
N6 .2.9.420..... Permit for 14--story..sing-le
f 4TRUY...d.v.p-I I jag.............................................
Location L.o.t...#.6.4.....D.e.r.by..AKive...................
.. . . .. ......
West Barnstable
...............................................................................
Owner ............S..J...S..TRUST...................I...........
Type of Construction ............frame...................
. ................................................... ............................
Plot ............................ Lot ................................
Permit Granted ...................M4Y.'.2.9.......1986
Date of Inspection 7S.78,a..................19
Date Completed ...................19
orb, 7.
j,
Assessor's map and lot number .. ..... ........,... THE
Sewage Permit number .............g ... ..... .................
^ / Z BASH9TAXLE, i
House number......... .. ... ... .�.�^:....................... 90 Mnea
1639-
'FD MAX 6�9
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO `:.:......................
�? s
TYPE OF .CONSTRUCTION ..... .1,& ( ..O . � .�..:.. : ... ,..:--...................................................
.............................
TO THE INSPECTOR OF BUILDINGS:
The undersigned here y applies for a permit according to/o the following/iinformati
Location ....... ...:....( '...... ..... �Y 6!:.l!.:. .. h��!.�. !.`'...... .. .........
.� :.
Proposed Use ...... 1!1 �:�,:.� �f .r%a..................................................... ............ .✓....................................................
... ..... ..
Zoning District ..........�..r.................................................Fire District .........� ...:..1.. ............................................
.....
;1 -�.Y / / Q
Name of Owner ........... �:. x -. .:...............�/.w?.L.....Address ....V..�)............!.1..,..1 .... Z ../... .�1J/(/15
/--mil ..... ���'<< %�
Name of Builder Address ....................................... . ......... .................... .
Name of Architect .. ����% !.!��11.....:....�.: •7� ddress .................. .
Number of Rooms ................ ...y/............................................Foundation ............................�/ �� !!21..�
............................................... .
Exterior ..... % �/'Y ./ .`..: ..........................................Roofing ............... ... ..... . . .............................................
Floors :Interior VIP
Heating ( .............��.....................................Plumbing ....... ....;�/......./.,.. / � .......&17
71
Fireplace .................. /:..../ Approximate. Cost `')..J.... �d 1.......
........ ............... ;/
Definitive Plan Approved by Planning Board ____I'�� 4%_t�_t'`!__�-l_____19_ C,' Area . O S j �... a .................
Diagram of Lot and Building with Dimensions Fee 6
........... .....................
SUBJECT TO APPROVAL OF BOARD OF HEALTH ( J.O.
I 10-
,
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarclin,g the above
construction.
Name , / �G :. V�vr1��
.y
f
J.
Construction Supervisor's License yv 7✓
S L S TRUST A=151-4 & 6
No .... Permit for ... ...............
single..f m
........................
Location ....L.Qt�JMA....1).ex.bY..Dxive....... ......
......We.s.t...BgrA,9tabjp.........................................
O.wner 5..L..S...Trus.t.............................. ...........
Type of Construction .............game..................
................................................................................
Plot ............................ Lot*..................................
Permit Granted ....................;.May.. ......1986
Date of Inspection- ..............................19
Date Completed ......................................19
Co�� I�� IU
I �
o��e�♦ TOWN OF BARNSTABLE Permit No. .2.942U
BUILDING DEPARTMENT
{ "';a TOWN OFFICE BUILDING Cash �;
' 29.63
uv HYANNIS,MASS.02601 Bond �
i
CERTIFICATE OF USE AND OCCUPANCY
Issued to S L S Truut
Address Lot 4;64, 23 Derby Lune
11,:st Barnstable, Rasilachusetts
USE GROUP FIRE GRADING OCCUPANCY LOAD
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE.
1
Septembur 25, 86
19................. ...........................................
Building Inspector